In the JournalsPerspective

Glucosamine supplementation may hinder type 2 diabetes development

Lu Qi

Adults who take glucosamine supplements may be less likely to develop type 2 diabetes compared with those who do not take extra glucosamine, especially if they also have elevated levels of C-reactive protein, according to findings published in Diabetes Care.

“This is the first prospective study reporting the potential beneficial effects of glucosamine use on diabetes,” Lu Qi, MD, PhD, HCA Regents distinguished chair and professor in the department of epidemiology at Tulane University School of Public Health and Tropical Medicine, and director of the Tulane University Obesity Research Center in New Orleans, told Healio. “The results are exciting, but not very surprising, because there [is] prior evidence supporting our findings.”

Qi and colleagues evaluated type 2 diabetes development across 8.1 years of median follow-up among 404,508 adults from the UK Biobank who did not have diabetes at baseline. Researchers categorized glucosamine users (n = 78,588; mean age, 58.6 years; 63.1% women) and nonusers (n = 325,920; mean age, 55.1 years; 53.6% women) based on information from a questionnaire completed between 2006 and 2010. Follow-up surveys were completed between 2012 and 2013 and in 2014. The researchers evaluated C-reactive protein levels in blood samples taken between 2006 and 2010 and identified diagnoses of type 2 diabetes in medical records.

In fully adjusted models, those who took glucosamine had a 20% reduction in type 2 diabetes risk vs. those who did not (OR = 0.81; 95% CI, 0.76-0.86). The researchers carried out additional analyses using different exclusion criteria, such as an HbA1c of 6.5% or more, and still observed a reduction in risk with glucosamine. In addition, the reduction was “more pronounced in participants with high C-reactive protein levels.”

“The study reported novel findings, which may motivate further investigations on the potential mechanisms,” Qi said. “The results suggest potential beneficial effects of glucosamine use on diabetes.” – by Phil Neuffer

For more information:

Lu Qi, MD, PhD, can be reached at lqi1@tulane.edu.

Disclosures: The authors report no relevant financial disclosures.

Lu Qi

Adults who take glucosamine supplements may be less likely to develop type 2 diabetes compared with those who do not take extra glucosamine, especially if they also have elevated levels of C-reactive protein, according to findings published in Diabetes Care.

“This is the first prospective study reporting the potential beneficial effects of glucosamine use on diabetes,” Lu Qi, MD, PhD, HCA Regents distinguished chair and professor in the department of epidemiology at Tulane University School of Public Health and Tropical Medicine, and director of the Tulane University Obesity Research Center in New Orleans, told Healio. “The results are exciting, but not very surprising, because there [is] prior evidence supporting our findings.”

Qi and colleagues evaluated type 2 diabetes development across 8.1 years of median follow-up among 404,508 adults from the UK Biobank who did not have diabetes at baseline. Researchers categorized glucosamine users (n = 78,588; mean age, 58.6 years; 63.1% women) and nonusers (n = 325,920; mean age, 55.1 years; 53.6% women) based on information from a questionnaire completed between 2006 and 2010. Follow-up surveys were completed between 2012 and 2013 and in 2014. The researchers evaluated C-reactive protein levels in blood samples taken between 2006 and 2010 and identified diagnoses of type 2 diabetes in medical records.

In fully adjusted models, those who took glucosamine had a 20% reduction in type 2 diabetes risk vs. those who did not (OR = 0.81; 95% CI, 0.76-0.86). The researchers carried out additional analyses using different exclusion criteria, such as an HbA1c of 6.5% or more, and still observed a reduction in risk with glucosamine. In addition, the reduction was “more pronounced in participants with high C-reactive protein levels.”

“The study reported novel findings, which may motivate further investigations on the potential mechanisms,” Qi said. “The results suggest potential beneficial effects of glucosamine use on diabetes.” – by Phil Neuffer

For more information:

Lu Qi, MD, PhD, can be reached at lqi1@tulane.edu.

Disclosures: The authors report no relevant financial disclosures.

    Perspective
    Laura Shane-McWhorter

    Laura Shane-McWhorter

    Many people use glucosamine, particularly for knee osteoarthritis and joint pain. This prospective cohort observational study assessed the possible correlation of risk for type 2 diabetes and glucosamine use. A theoretical mechanism is that inflammation may contribute to type 2 diabetes onset and glucosamine exhibits some anti-inflammatory effects.

    The evaluation determined that there was a 17% lower risk for type 2 diabetes with glucosamine use (HR 0.83; 95% CI of 0.78 to 0.89). The investigators also found a significant inverse correlation of higher baseline C-reactive protein levels (P = 0.02), and type 2 diabetes genetic risk score did not influence the correlation.

    The researchers calculated various sensitivity analyses and found the inverse correlation of glucosamine use with incident type 2 diabetes remained consistent. Study strengths included the large sample size, validated biomarker measures and the consistent results in sensitivity analyses using different models. 

    This study’s major limitation was the observational study design, and thus causality cannot be determined. A highly relevant issue is one that exists for many studies involving supplements. There was no verification of formulations, dose or duration of glucosamine use. Moreover, the inverse relationship of C-reactive protein levels and glucosamine use might be due to chance. The investigators were not able to exclude that glucosamine use may be an indicator of healthy lifestyle. 

    Overall, glucosamine use was associated with lower type 2 diabetes risk in this study. However, it is imperative that randomized controlled trials be conducted to determine whether this association may be verified.

    • Laura Shane-McWhorter, PharmD, BCPS, BC-ADM, CDCES, FASCP, FADCES
    • Professor emeritus
      Department of pharmacotherapy
      University of Utah College of Pharmacy
      Salt Lake City

    Disclosures: Shane-McWhorter reports she has written and reviewed information for the Merck Manual on dietary supplements.